Platelet-Rich Plasma: From Basic Science to Clinical Applications

ArticleinThe American Journal of Sports Medicine 37(11):2259-72 · November 2009with90 Reads
DOI: 10.1177/0363546509349921 · Source: PubMed
Abstract
Platelet-rich plasma (PRP) has been utilized in surgery for 2 decades; there has been a recent interest in the use of PRP for the treatment of sports-related injuries. PRP contains growth factors and bioactive proteins that influence the healing of tendon, ligament, muscle, and bone. This article examines the basic science of PRP, and it describes the current clinical applications in sports medicine. This study reviews and evaluates the human studies that have been published in the orthopaedic surgery and sports medicine literature. The use of PRP in amateur and professional sports is reviewed, and the regulation of PRP by antidoping agencies is discussed.
    • "The use of PRP speeds up the neovascularization and therefore increase the blood supply and nutrients influx necessary for cell regeneration in damaged tissue. Also, by increasing the blood supply, PRP stimulates the requirement, proliferation and differentiation of the cells, which are involved in the healing process [3]. The purpose of this article is to elucidate the PRP components, the role of some PRP growth factors in tissue repair and to discuss how certain PRP components may modulate the healing process. "
    [Show abstract] [Hide abstract] ABSTRACT: Platelet rich plasma (PRP) represents a relatively new approach in regenerative medicine. It is obtained from patient’s own blood and contains different growth factors and other biomolecules necessary for wound healing. Since there are various protocols for PRP preparing, it usually results with PRP generation with different amounts of bioactive substances, which finally may modulate the intensity of wound healing. The reference data about potential effect of some PRP compounds on wound healing, in different tissues, are still controversial. This review summarizes recently known facts about physiological role of certain PRP components and guidance for further research. Also, this review discusses different procedure for PRP generation and potential effect of leukocytes on wound healing.
    Full-text · Article · Aug 2016
    • "" Platelet gel " or " platelet-rich plasma " is being used in a wide range of clinical settings such as bone healing, muscle injury, plastic surgery, and orthopedic surgery [23] . The beneficial effects of platelets in these settings have been mainly attributed to various growth factors and cytokines from platelet α-granules [23]. Our study provides another solid theoretical background for " platelet therapy, " which activates and recruits late EPCs through LPA-Edg-2 axis leading to vasculogenesis and tissue regeneration. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Peroxisome proliferator-activated receptor (PPAR)-δ is a nuclear receptor regulating cell metabolism. The role of PPAR-δ in late endothelial progenitor cells (EPCs) has not been fully elucidated. We aim to understand the effects of PPAR-δ activation on late EPC and to reveal the underlying mechanism. Methods and results: Treatment with a highly selective PPAR-δ agonist (GW501516) induced proliferation of late EPCs and enhanced their vasculogenic potential. Search for the target molecule of PPAR-δ activation revealed endothelial differentiation gene (Edg)-2. Chromatin immunoprecipitation and promoter assays demonstrated that Edg-2 gene was specifically induced by PPAR-δ through direct transcriptional activation. Lysophosphatidic acid (LPA), an Edg ligand, mimicked the pro-vasculogenic effects of GW501516 in late EPCs whereas Edg antagonist (Ki16425) blocked these effects. Edg-2 is a membrane receptor for LPA which is a major growth factor from activated platelets. Thus, the interaction between platelets and late EPCs via the LPA-Edg-2 axis was assessed. Platelet supernatant boosted the pro-vasculogenic effects of GW501516, which was reversed by antagonist to PPAR-δ (GSK0660) or Edg (Ki16425). Both of in vivo Matrigel plug model and mouse skin punch-wound model demonstrated that the combination of platelets and PPAR-δ-activated late EPCs synergistically enhanced vascular regeneration. Conclusions: There exists a synergistic interaction between human platelets and late EPCs leading to vascular regeneration. This interaction consists of LPA from platelets and its receptor Edg-2 on the surface of EPCs and can be potentiated by PPAR-δ activation in EPCs. A PPAR-δ agonist is a good candidate to achieve vasculogenesis for ischemic vascular disease.
    Full-text · Article · Jun 2016
    • "The use of platelet-rich plasma (PRP) for muscle injures is based on the effects that growth factors have on the stimulation and acceleration of tissue regeneration. PRP has been studied as a primary or adjunctive treatment for acute tendon rupture [3, 6], articular cartilage injury [10] , ligament sprains [28], and osteoarthritis [26]. However, only a few studies with conflicting findings are available in the literature regarding its use in muscle injuries [12, 24, 25]. "
    [Show abstract] [Hide abstract] ABSTRACT: Purpose The aim of this study is to report the effects of autologous PRP injections on time to return to play and recurrence rate after acute grade 2 muscle injuries in recreational and competitive athletes. Methods Seventy-five patients diagnosed with acute muscle injuries were randomly allocated to autologous PRP therapy combined with a rehabilitation programme or a rehabilitation programme only. The primary outcome of this study was time to return to play. In addition, changes in pain severity and recurrence rates were evaluated. Results Patients in the PRP group achieved full recovery significantly earlier than controls (P = 0.001). The mean time to return to play was 21.1 ± 3.1 days and 25 ± 2.8 days for the PRP and control groups, respectively (P = 0.001). Significantly lower pain severity scores were observed in the PRP group throughout the study. The difference in the recurrence rate after 2-year-follow-up was not statistically significant between groups. Conclusions A single PRP injection combined with a rehabilitation programme significantly shortened time to return to sports compared to a rehabilitation programme only. Recurrence rate was not significantly different between groups. Level of evidence I.
    Full-text · Article · Apr 2016
Show more